Silver-Impregnated Dressings for Catheter Exit-Site and Tunnel Infections in Peritoneal Dialysis Patients

The goal of this clinical trial is to evaluate the feasibility and acceptability of using silver-impregnated dressings, compared to standard daily topical antibiotic exit-site dressings, for the management of catheter exit-site infection or tunnel infection in adult patients undergoing peritoneal dialysis. The study also aims to explore infection resolution, safety, and clinical outcomes associated with this alternative exit-site care approach. The main questions it aims to answer are: Is the use of silver-impregnated dressings feasible and acceptable for peritoneal dialysis patients with exit-site or tunnel infection? Does the use of silver-impregnated dressings result in faster resolution of catheter exit-site or tunnel infection? Does replacing daily topical antibiotic dressings with silver-impregnated dressings reduce the frequency of dressing changes and the time spent on exit-site care? Are there any adverse events associated with the use of silver-impregnated dressings? What infection-related clinical outcomes occur, including recurrence of infection, need for catheter removal, or infection-related hospitalisation? Standard management of catheter exit-site or tunnel infection typically includes daily exit-site cleansing, application of topical antibiotics, sterile dressing coverage, and systemic antibiotic therapy. Despite these treatments, some patients continue to experience persistent or recurrent infections and adverse outcomes such as peritonitis, catheter loss, or transfer to haemodialysis. Participants will: Be randomly assigned to receive either silver-impregnated dressings or standard exit-site care with daily topical antibiotic dressings as alternative approaches to local exit-site management Continue to receive systemic antibiotics according to current clinical guidelines Attend regular clinic visits for exit-site assessment and monitoring Be followed for up to twelve weeks to evaluate feasibility, safety, patient experience, and infection-rel